[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4549 Introduced in House (IH)]







106th CONGRESS
  2d Session
                                H. R. 4549

To amend title XVIII of the Social Security Act to provide for payment 
       under the Medicare Program for ambulance services for the 
 transportation of Medicare beneficiaries to certain rural outpatient 
                              facilities.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 25, 2000

  Mr. Aderholt (for himself, Mr. Bachus, Mr. Riley, Mrs. Emerson, Mr. 
Sandlin, Mr. Gilchrest, Mr. Oberstar, Mr. McHugh, Mr. Baldacci, and Mr. 
    Towns) introduced the following bill; which was referred to the 
  Committee on Commerce, and in addition to the Committee on Ways and 
 Means, for a period to be subsequently determined by the Speaker, in 
   each case for consideration of such provisions as fall within the 
                jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
To amend title XVIII of the Social Security Act to provide for payment 
       under the Medicare Program for ambulance services for the 
 transportation of Medicare beneficiaries to certain rural outpatient 
                              facilities.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicare Ambulance Transportation 
Service Improvement Act of 2000''.

SEC. 2. COVERAGE OF AMBULANCE SERVICES TO QUALIFIED OUTPATIENT 
              FACILITIES.

    (a) In General.--Section 1861(e) of the Social Security Act (42 
U.S.C. 1395x(e)) is amended by adding at the end the following: ``For 
purposes of subsection (s)(7), such term also includes a qualified 
outpatient facility (as defined in subsection (uu)).''.
    (b) Definition of Qualified Outpatient Facility.--Section 1861 of 
the Social Security Act (42 U.S.C. 1395x) is amended by adding at the 
end the following new subsection:

                    ``Qualified Outpatient Facility

    ``(uu) The term `qualified outpatient facility' means an outpatient 
facility located in a rural area (as defined in 1886(d)(2)(D)) that 
meets the following requirements:
            ``(1) Services furnished.--The facility furnishes some of 
        the outpatient services furnished by a hospital, such as 
        emergency services, diagnostic imaging, ambulatory surgery, 
        catheterization lab, physicians' services, wellness centers and 
        health education libraries, urgent care, birthing services, 
        laboratory, and other essential support services (including 
        information and communication systems).
            ``(2) Limitation on length of stay.--The length of stay 
        permitted in the facility is less than 24 hours.
            ``(3) Emergency room coverage.--During the operating hours 
        of the facility, the facility makes available emergency care 
        services that are necessary for ensuring access to such 
        services in the rural area.
            ``(4) Transfer agreements.--The facility has an agreement 
        with a hospital with respect to each of the following:
                    ``(A) Patient referral and transfer.
                    ``(B) The provision of emergency and non-emergency 
                transportation between the facility and the hospital.
                    ``(C) Communications systems for sharing patient 
                data.
            ``(5) Protocols with providers of ambulances services.--The 
        facility has established protocols with providers of ambulance 
        services to ensure that the transportation of individuals to 
        the facility is limited to individuals with medical conditions 
        that are suitable for treatment in the facility in accordance 
        with a State medical control plan, or in the absence of such a 
        plan, in accordance with medical control guidelines established 
        by the Secretary.
            ``(6) Designated necessary rural provider.--The facility is 
        located in one of the following areas:
                    ``(A) An area designated (under section 
                332(a)(1)(A) of the Public Health Service Act) as a 
                health professional shortage area.
                    ``(B) A rural area designated by the Secretary as 
                medically underserved under section 330(b)(3) of the 
                Public Health Service Act.
                    ``(C) A county in a State which has an unemployment 
                rate greater than the statewide average unemployment 
                rate.
                    ``(D) A county in a State in which the percentage 
                of residents aged 65 and older is greater than the 
                statewide average percentage for such residents.
                    ``(E) A county in a State in which the percentage 
                of families with incomes below 200 percent of the 
                income official poverty line (as defined by the Office 
                of Management and Budget, and revised annually in 
                accordance with section 673(2) of the Omnibus Budget 
                Reconciliation Act of 1981) applicable to a family of 
                the size involved is higher than the statewide average 
                for such families with such incomes.''.
    (c) Effective Date.--The amendment made by subsection (a) applies 
with respect to ambulance services furnished on or after the date of 
the enactment of this Act.
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